* 1. How did you learn about the survey?

* 2. Were you aware that the Bethlehem Health Bureau offered free sexually transmitted disease (STD) counseling, testing and treatment?

* 3. Were you aware that the Bethlehem Health Bureau offered free family planning services (birth control, annual exams, pregnancy testing, etc.)?

* 4. A good location for the Family Planning/STD clinic would be (check as many as apply):

* 5. When is the best time of day to have the Family Planning/STD Clinic (check as many that apply)?

* 6. How can we better promote the Family Planning/STD Clinic to the community?

* 7. I identify my gender as...

* 8. What is your age?

* 9. What is your race/ethnicity?

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